Provider Demographics
NPI:1962229682
Name:REEVES, SARAI QUINICE (ANT, WNT, MNT)
Entity type:Individual
Prefix:
First Name:SARAI
Middle Name:QUINICE
Last Name:REEVES
Suffix:
Gender:F
Credentials:ANT, WNT, MNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37616 FORD RD STE 204
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-1924
Mailing Address - Country:US
Mailing Address - Phone:401-646-4325
Mailing Address - Fax:
Practice Address - Street 1:37616 FORD RD STE 204
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1924
Practice Address - Country:US
Practice Address - Phone:401-646-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI24214140827225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist